Objective: Leveraging data from the UK Biobank, this study investigated the association between adverse childhood experiences (ACEs) and anxiety/depression comorbidity among patients with irritable bowel syndrome (IBS). Whether any potential association was specific to the IBS population was also evaluated. Methods: This was a retrospective case-control study. The data extraction cutoff date was October 6, 2023. A total of 11 027 patients with diagnosed IBS were included as the case group for primary analysis, and 144 536 non-IBS participants from the same period were included as the control group for specificity verification. Multivariate logistic regression models were used to assess the association between ACEs and anxiety/depression, adjusting for potential confounding factors, including age, sex, adverse life events in adulthood, smoking, alcohol consumption, body mass index (BMI), socioeconomic status, and overall health. Subgroup analyses were further conducted stratified by age and sex. Finally, interaction analyses were performed to test whether the impacts of ACEs differed between the IBS and control groups. Results: The prevalence of comorbid anxiety or depression among the 11 027 patients with IBS was 32.09%. Multivariate analysis revealed that compared with patients with no history of ACEs, those reporting two or more ACEs had a 97% increased risk of comorbidity (OR=1.97, 95%CI 1.73-2.24). Each one-point increase in the total ACE score was associated with a 22% increased risk of comorbidity (OR=1.22, 95%CI 1.15-1.29). Among specific ACE types, emotional neglect (OR=1.90, 95%CI 1.66-2.19) and emotional abuse (OR=1.71, 95%CI 1.52-1.92) showed the strongest associations with comorbid anxiety/depression. Subgroup analyses indicated that these associations remained statistically significant across sexes, as well as in participants aged both 60 years and older and younger than 60 years. Interaction analyses revealed that the risk for anxiety/depression risk associated with ACEs did not differ significantly between the IBS and control groups; each one-point increase in the total ACE score was associated with a similar increase in risk in the IBS group (OR=1.22, 95%CI 1.15-1.29) and the control group (OR=1.24, 95%CI 1.21-1.27), with no statistically significant difference in effect size. Conclusion: ACEs, particularly emotional trauma, are robustly associated with anxiety and depression comorbidity among patients with IBS. Although the association appears consistent between IBS patients and the general population, IBS patients with a history of emotional trauma exhibit a higher prevalence of psychological comorbidity. Thus, they represent a high-risk group that warrants clinical prioritization. 目的： 基于英国生物银行（UK Biobank）数据库，探究童年期不良经历（ACEs）与肠易激综合征（IBS）患者伴发焦虑/抑郁共病的关联，并进一步分析该关联在IBS人群中是否具有特异性。 方法： 本研究为病例对照研究。数据提取截止日期为2023年10月6日。纳入确诊IBS的患者11 027例作为病例组做主要分析，并引入同期非IBS参与者144 536例作为对照组以进行特异性验证。采用多因素logistic回归模型评估ACEs与焦虑/抑郁的关联，校正年龄、性别、成年负性生活事件、吸烟、饮酒、体重指数、社会经济地位及总体健康等混杂因素，并进一步分年龄和性别进行亚组分析。最后，通过交互作用分析检验该关联在IBS组与对照组间的差异。 结果： 在11 027例IBS患者中，焦虑或抑郁共病的患病率为32.09%。多因素分析显示，与无ACEs暴露的患者相比，经历≥2次ACEs的患者共病风险增加97%（OR=1.97，95%CI 1.73~2.24）。ACEs总分每增加1分，共病风险增加22%（OR=1.22，95%CI 1.15~1.29）。在特定类型中，情感忽视（OR=1.90，95%CI 1.66~2.19）和情感虐待（OR=1.71，95%CI 1.52~1.92）的关联最为显著。亚组分析显示，该关联在男性和女性以及≥60岁及<60岁的群体中差异均有统计学意义。交互作用分析显示，ACEs与IBS状态对焦虑/抑郁风险无显著交互影响，ACEs总分每增加1分，IBS组（OR=1.22，95%CI 1.15~1.29）与对照组（OR=1.24，95%CI 1.21~1.27）的风险增加幅度差异无统计学意义。 结论： ACEs，特别是情感性创伤，是IBS患者伴焦虑/抑郁共病的稳健关联因素。尽管该关联在IBS患者与普通人群中表现一致，但鉴于IBS患者较高的心理共病患病率，有情感性创伤史的IBS患者仍是需临床优先关注的高危人群。.
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